Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Dec 24, 2022; 13(12): 980-983
Published online Dec 24, 2022. doi: 10.5306/wjco.v13.i12.980
Circulating tumour DNA in gastrointestinal cancer in clinical practice: Just a dream or maybe not?
Andrea Pretta, Eleonora Lai, Clelia Donisi, Dario Spanu, Pina Ziranu, Valeria Pusceddu, Marco Puzzoni, Elena Massa, Mario Scartozzi
Andrea Pretta, Eleonora Lai, Clelia Donisi, Dario Spanu, Pina Ziranu, Valeria Pusceddu, Marco Puzzoni, Elena Massa, Mario Scartozzi, Medical Oncology Unit, University Hospital and University of Cagliari, Monserrato 09042, Cagliari, Italy
Author contributions: Pretta A, Lai E, Donisi C, Spanu D, Ziranu P, Pusceddu V, Puzzoni M, Massa E, and Scartozzi M wrote and edited the manuscript.
Conflict-of-interest statement: Eleonora Lai has received advisory board and consultant fees from AstraZeneca and MSD. Mario Scartozzi has received consultant, advisory board and speakers’ bureau fees from Amgen, Sanofi, MSD, EISAI, Merck, Bayer.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eleonora Lai, MD, PhD, Staff Physician, Medical Oncology Unit, University Hospital and University of Cagliari, SS 554, km 4,500, bivio per Sestu, Monserrato 09042, Cagliari, Italy. eleonora.lai@unica.it
Received: August 18, 2022
Peer-review started: August 18, 2022
First decision: September 5, 2022
Revised: September 16, 2022
Accepted: November 21, 2022
Article in press: November 21, 2022
Published online: December 24, 2022
Processing time: 117 Days and 17.5 Hours
Abstract

The evaluation of circulating tumor DNA (ctDNA) is increasingly integrated into the management of diagnosis and treatment of gastrointestinal cancer as it represents an innovative and minimally invasive biomarker that could allow us to reach clinical needs not met yet in randomized clinical trials. Recent research provided an interesting overview of the role of circulating tumor DNA in gastric, biliary, liver, pancreatic, and colorectal cancer. Data regarding upper gastrointestinal tumors are currently not practice changing. Tumor detection rates are low in the early stages, while in advanced stages ctDNA is useful for molecular tracking evaluation. Most of the evidence comes from colorectal cancer studies, where ctDNA was evaluated both in the early and advanced stages with the post-surgery minimal residual disease assessment and the response assessment, respectively. ctDNA qualifies as a promising tool in the era of precision medicine, with potential applications in the entire management of gastrointestinal cancer patients. Further evidence is needed to establish which setting may be influenced greatly by liquid biopsy in clinical practice.

Keywords: Circulating tumor DNA; Gastrointestinal cancer; Liquid biopsy; Esophageal cancer; Gastric cancer; Liver cancer; Bile duct cancer; Pancreatic cancer; Colorectal cancer

Core Tip: Circulating tumor DNA is a promising tool in the era of precision medicine, with several potential applications in the entire management of gastrointestinal malignancies. Further evidence is needed to assess in which setting liquid biopsy might have a greater impact in clinical practice.